Pregnancy Outcomes After One Anastomosis Gastric Bypass

One anastomosis gastric bypass (OAGB) is gaining increasing acceptance worldwide. Pregnancy outcomes after OAGB have been understudied. We aimed to examine associations of OAGB with maternal and perinatal outcomes.

The study group comprised women who delivered after OAGB during 2017-2024 in a university hospital. A control group was established by matching preoperative body mass index, age, delivery history, and delivery year.

Overall, 50 OAGB and 50 matched control parturients were included. In the OAGB group, rates of gestational hypertensive disorders (2.0% vs. 10.0%, P = 0.008) and gestational diabetes mellitus (4.0% vs. 18.0%, P = 0.05) were significantly lower compared with the control group. For the OAGB group, hemoglobin levels were lower at both early pregnancy (11.5 vs. 13.1 g/dL, P < 0.001) and pre-delivery (10.4 vs. 10.9 g/dL, P = 0.008), with a higher proportion of patients requiring intravenous iron supplementation (24.0% vs. 2.0%, P = 0.002). Rate of induction of labor was lower within the OAGB group (12.5% vs. 36.1%, P = 0.03), while gestational age at delivery and mode of delivery were similar between the groups. For the OAGB group, birthweight was significantly lower (2900 vs. 3392 grams, P < 0.001) with a higher proportion of small-for-gestational-age infants (28.0% vs. 6.0%, P = 0.006) and a lower proportion of large-for-gestational-age infants (2.0% vs. 24.0%, P = 0.002).

OAGB was associated with reduced rates of gestational diabetes mellitus, gestational hypertensive disorders, excessive fetal growth, and induction of labor; and an increased rate of small-for-gestational-age infants. Hemoglobin levels were lower throughout pregnancy among OAGB patients, with a higher incidence of intravenous iron supplementation.